PCORI implementation projects promote the use of findings from PCORI-funded studies in real-world healthcare and other settings. These projects build toward broad use of evidence to inform healthcare decisions.
This PCORI-funded implementation project is using shared decision making, or SDM, to help women with uterine fibroids and their doctors make decisions about treatment.
|Uterine fibroids are growths in the uterus that are not cancer. They are a common health problem and can cause heavy bleeding, pain, problems with pregnancy, and preterm birth. Treatments are available for uterine fibroids; these treatments have different trade-offs.|
What is the goal of this implementation project?
SDM is a process where patients and clinicians, like doctors or nurses, work together to make health decisions. Discussing the evidence for different treatments is usually part of SDM.
This project is making evidence from a PCORI-funded research study part of an SDM program. This program helps patients with fibroids and their clinicians discuss the benefits and risks of treatment options. The original research study compared three ways of treating fibroids:
- Myomectomy, which is surgery to remove fibroids
- Uterine artery embolization, which is a procedure to block the flow of blood to fibroids
- Endometrial ablation, which is a procedure that removes a layer of the uterus lining
All three treatment options worked about the same to prevent or delay symptoms. Myomectomy and uterine artery embolization were better than endometrial ablation at helping patients avoid follow-up treatment.
What will this project do?
The project team is working with gynecology clinics in five states to make the SDM program part of regular care. First, the team is updating an existing decision aid with evidence on fibroid treatments from the study. The decision aid can be used before, during, or after clinic visits. The aid comes in multiple formats, including paper-based, picture-based, or online. It is available in English and Spanish.
Then, the project team is supporting clinics by:
- Assessing how ready clinics are to support patients and doctors in making shared decisions about fibroid treatments.
- Helping each clinic identify which formats they want to use and how to make the decision aid part of routine care.
- Making the decision aid part of online systems that clinics use to share materials with patients.
- Training and providing support in SDM for clinical teams, including doctors, nurses, and other clinic staff.
What is the expected impact of this project?
The project will demonstrate how to make the SDM program for uterine fibroids part of routine care at gynecology clinics. About 2,600 patients and 30–40 clinicians will receive the program. The project evaluation will confirm that the program is working as intended to help patients and doctors make shared decisions about treatment.
More about this implementation project:
Stakeholders Involved in This Project
To document implementation:
To assess healthcare and health outcomes:
To reduce the risk of spreading the COVID-19 virus, many health systems are pausing in-person care. In its place, they are using telehealth. Telehealth provides care to patients remotely using phone, video, or monitoring devices that can help manage care.
With the enhancement, the project team will support patients using telehealth to make decisions about treatments for uterine fibroids. Instead of viewing the decision aid in person, the team will send it directly to patients. The team will work with each clinic to figure out how to best offer the decision aid, such as online or mailing a paper copy.
Enhancement Award Amount: $499,970
Related Journal Citations
Study Registration Information
Initial PCORI-Funded Research Study
This implementation project focuses on putting findings into practice from this completed PCORI-funded research study: Which Treatments for Uterine Fibroids Have the Best Results?
Related Dissemination and Implementation Project
Supporting Ongoing Use of Two Conversation Aids for Making Decisions about Early-Stage Breast Cancer Treatment -- The SHAIR Collaborative